Dataset Information

Use of Coronary Computed Tomographic Angiography to Guide Management of Patients With Coronary Disease.

ABSTRACT:

Background

In a prospective, multicenter, randomized controlled trial, 4,146 patients were randomized to receive standard care or standard care plus coronary computed tomography angiography (CCTA).

Objectives

The purpose of this study was to explore the consequences of CCTA-assisted diagnosis on invasive coronary angiography, preventive treatments, and clinical outcomes.

Methods

In post hoc analyses, we assessed changes in invasive coronary angiography, preventive treatments, and clinical outcomes using national electronic health records.

Results

Despite similar overall rates (409 vs. 401; p = 0.451), invasive angiography was less likely to demonstrate normal coronary arteries (20 vs. 56; hazard ratios [HRs]: 0.39 [95% confidence interval (CI): 0.23 to 0.68]; p < 0.001) but more likely to show obstructive coronary artery disease (283 vs. 230; HR: 1.29 [95% CI: 1.08 to 1.55]; p = 0.005) in those allocated to CCTA. More preventive therapies (283 vs. 74; HR: 4.03 [95% CI: 3.12 to 5.20]; p < 0.001) were initiated after CCTA, with each drug commencing at a median of 48 to 52 days after clinic attendance. From the median time for preventive therapy initiation (50 days), fatal and nonfatal myocardial infarction was halved in patients allocated to CCTA compared with those assigned to standard care (17 vs. 34; HR: 0.50 [95% CI: 0.28 to 0.88]; p = 0.020). Cumulative 6-month costs were slightly higher with CCTA: difference $462 (95% CI: $303 to $621).

Conclusions

In patients with suspected angina due to coronary heart disease, CCTA leads to more appropriate use of invasive angiography and alterations in preventive therapies that were associated with a halving of fatal and non-fatal myocardial infarction. (Scottish COmputed Tomography of the HEART Trial [SCOT-HEART]; NCT01149590).

SUBMITTER: Williams MC

PROVIDER: S-EPMC4829708 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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Publications

Use of Coronary Computed Tomographic Angiography to Guide Management of Patients With Coronary Disease.

Williams Michelle C MC Hunter Amanda A Shah Anoop S V ASV Assi Valentina V Lewis Stephanie S Smith Joel J Berry Colin C Boon Nicholas A NA Clark Elizabeth E Flather Marcus M Forbes John J McLean Scott S Roditi Giles G van Beek Edwin J R EJR Timmis Adam D AD Newby David E DE

Journal of the American College of Cardiology 20160401 15

<h4>Background</h4>In a prospective, multicenter, randomized controlled trial, 4,146 patients were randomized to receive standard care or standard care plus coronary computed tomography angiography (CCTA).<h4>Objectives</h4>The purpose of this study was to explore the consequences of CCTA-assisted diagnosis on invasive coronary angiography, preventive treatments, and clinical outcomes.<h4>Methods</h4>In post hoc analyses, we assessed changes in invasive coronary angiography, preventive treatment ...[more]

PMID: 27081014

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Dataset Information

Use of Coronary Computed Tomographic Angiography to Guide Management of Patients With Coronary Disease.

Background

Objectives

Methods

Results

Conclusions

Publications

Use of Coronary Computed Tomographic Angiography to Guide Management of Patients With Coronary Disease.

Similar Datasets

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